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TMI: Tales From a Transvaginal Ultrasound

Transvaginal. This was not a word that either existed in my vocabulary prior to having just such a scan, or that my GP thought to mention as she referred me for an ultrasound with a breezy, “I’m sure they won’t find anything, but it’s best just to check.” The reason for the referral was that my period had turned into a homicidal maniac and the Pill was having little to no effect on it. It was time to start exploring other options, including a range of growths, cysts, wonky bits and tumours benign or otherwise that might be the cause of the problem.

Partly to find out exactly what might be found and partly to find out just what the scan would entail, I turned to Dr Google. It was here, thanks to the search terms ‘ultrasound’ and ‘period problems’, that the word ‘transvaginal’ first made its triumphant entry into my consciousness, about six weeks before it made one into my vagina.

As it turned out, this was around the same time that certain elements of the Republican Party in the US were embarking on a noble mission to educate the world on gynaecological matters by trying to make transvaginal ultrasounds mandatory for women seeking an abortion. As such, it was relatively easy to find women who were arguing against this by sharing their own experiences of transvaginal ultrasounds. In this context, recurrent phrases included ‘medical rape’ and ‘monster dildo probe’. These were not things that I wanted to read, much less have done to me. It sounded painful, invasive and incredibly embarrassing. Although forewarned is forearmed, I was therefore somewhat nervous as I made my way to the local hospital. What actually happened, however, was neither painful nor invasive – and the most awkward part of the whole thing was when my right ovary went temporarily AWOL.

This is how the scan went in 10 simple, pain- and embarrassment-free steps:

1.I nearly wet myself. This was not due to the fear of the “monster dildo probe”, but because an hour prior to a scan you have to drink 1.5 litres of water and I have a small bladder at the best of times. This would have been embarrassing, but wasn’t.

2. I nearly wet myself, version 2. Once called into the consulting room and introduced to the nurse and the nice (female) doctor, I then had a transabdominal scan, the sort that they give to pregnant women. This happens exactly like it does on TV, except expectant mothers are generally shown as joyous and/or serene, not wondering if they are about to watch their own bladders rupture on the ultrasound monitor. And while the gel really is that cold, another difference is that the transducer (the thing they hold on your stomach) is not used to glide gently over your skin, but is pressed in quite hard. Right on your painfully full bladder. On the monitor, my insides looked like a grey Ordnance Survey map, and the doctor could have, quite frankly, told me that I was gestating sextuplets as long as I was then able to go to the loo. This was uncomfortable, but mostly due to the bladder situation.

3. I was finally allowed to wee! Before moving on to the transvaginal scan, I was allowed to go and use the bathroom. This was the Best Wee Ever.

4. I prepared to meet the probe. Back in the room, and now looking a lot less like the pregnant women in the waiting area now my bladder was no longer distended, I was instructed to remove my pants, skirt and tights. I then hopped back on the bed and covered my lower half with the paper sheet thing that is always provided for these sorts of occasions. So far, so like any other pelvic exam. Had I not been used to pelvic exams, this would probably have been a bit embarrassing, but such are the perks of having a problem uterus.

5. I meet the probe. Once I was settled on the bed, the doctor showed me the probe and explained what would happen. The probe, which was to be inserted into my vagina, was perhaps 30cm long. This does not mean that all 30cm had to fit inside me, the length was to give the doctor room to hold and manipulate it properly. Girth-wise, it was probably as wide as a regular tampon and a half. Maybe two tampons at the very outset. While it did look very phallic, it was in no way “monster” in size. Here are some things that are wider than the probe and that you may insert into your vagina: one of more fingers, a mooncup, a penis, and actual dildo. The doctor explained that it would be inserted into my vagina up to my cervix and then gently moved around so that the various parts of my reproductive system could be examined in greater detail than allowed through the transabdominal scan. This was reassuring.

6. The probe prepares to meet me. Before inserting it, the doctor put a condom on the probe. An ordinary, NHS issue condom of the sort that are handed out in Family Planning clinics. There is nothing funnier than a phallic object wearing a condom that is clearly too big, flapping around. Then it was rolled around in so much lube that it spent the rest of the day squelching out of me and gently inserted. I was assured that it shouldn’t hurt and that if it was painful at any point, all I had to do was say and we could stop. Again, this was reassuring, and in the case of the condom, quite funny.

7. Cervix, meet probe. Although I was aware that the probe had been inserted, it was only when the end of it bumped into my cervix that I really felt it. Personally (and I’m probably not alone in this), I don’t like anything touching my cervix, so there was a bit of discomfort. At no point, however, was it painful, difficult or more than mildly embarrassing. The doctor then moved the probe around systematically, keeping a commentary so I knew what she was doing and what was being checked. With each movement, I could feel the probe against my cervix. This was a bit uncomfortable, not painful or even that invasive feeling.

8. My right ovary goes missing. After five or ten minutes, the doctor said, “OK, I’m just going to check your right ovary and then we’re done here”. There was some more movement against my cervix, and then some more, this time a little bit more insistent. This was a bit more uncomfortable, a sort of weird pushing feeling. Then it was announced that my right ovary could not be found and a second opinion would have to be sought. The nurse was dispatched to find another doctor.

9. I discuss Greek tragedy while a doctor holds an ultrasound probe in my vagina. It took about ten minutes to find another doctor, conversation had to be made and this was what I was studying at the time. I do not think that this is a typical part of a transvaginal scan. This was weird, and not something I mentioned in any of my essays.

10. My ovary is located. The second doctor arrived and took over the probe. To be honest, this was probably the most uncomfortable part of the whole thing, as it sort of felt like she was digging under my cervix to try and find the missing ovary. It was eventually located hiding behind my uterus. I was shown it on the monitor, as proof that it was there, but it just looked like more grey swirls. This was again uncomfortable, and a bit awkward as it was quite a small room and my knee kept getting in the way of the second doctor.

After this, the probe was withdrawn and I was allowed to clean up and put my clothes on. The doctor assured me that it didn’t look like there was anything there that shouldn’t be, but this would be confirmed with my GP once the images had been reviewed. Then I went home. Sadly, I was not given a picture of my uterus to flash around in the manner of an expectant parent. This had been the bit to which I had been most looking forward.

Since then, I have had a further two scans, both to check the position of my Mirena coil after the strings that you’re meant to be able to check went missing. Clearly, I have something of a talent for losing things around my uterus. Bar the case of the missing ovary, every single scan has followed roughly the same format, never painful and never anything to be scared of. If it is either of those things, then the doctor will stop and reassess the situation.

In short, transvaginal ultrasounds are neither as embarrassing nor as scary as they sound. But every once in a blue moon, they can be a great source of comedy.

This was hilarious and well timed. I had a transvaginal ultrasound last week, morbidly hungover, on my first day as a 21 year old. It felt like some weird rite of passage into womanhood.

Really not as horrendous as I thought it would be , although the technician did say ‘are you happy to have an internal scan?’ which was quickly followed up with ‘maybe happy isn’t the right word’. No love, not quite.

The reason that the Republican transvaginal ultrasound has been described in such strong terms is not because of the procedure itself, but the use to which male politicians wanted to put it: the punishment of women for accessing their legal right to abortion. I’m glad if people find this article reassuring about medically necessary ultrasounds, but it’s important to keep in mind that used as a tool of punishment and humiliation, it becomes a totally different thing, and that’s what US women were talking about.

I had a different experience than you. For me, the procedure was quite painful and the probe was definitely larger than you describe. I found the entire process to be extremely uncomfortable, physically and emotionally, so I don’t think the horror stories are exaggerations necessarily. Every woman is different, as are the doctors who perform transvaginal ultrasounds. My (female) doctor just happened to have rather poor bedside manner and seemed unconcerned/unaffected that I was practically sweating from the pain.

Thank you for writing this. As a 17 year old virgin, some of the Internet horror stories I’ve read have made me terrified for my first scan (tomorrow) and the prospect of losing my virginity to an alien probe whilst being positively strapped down.

Your experience made me laugh out loud and has eased my worrying quite a bit. After all, if it hurts too much I can always ask her to stop (I’ve been known, embarrassingly enough to actually do this in medical situations before. Get up and leave.)

And I’m less worried about the pain but more worried about bursting out laughing when I see a floppy condom-ed stick come hurtling towards me (hurtling isnt the right word. She isn’t going to throw it. Shut up brain)

I got myself worked up when I was sent to have an ultrasound in January 2012 but I was told by someone on the phone from the X-ray dept not to panic, it was only the ‘jelly on the belly’ one. I wasn’t aware there was any other at that time. When I got there I was obviously desperate for a wee because of being full of water & I was also dying for a cr*p too as I’d had diarrhoea all day with anxiety, worrying about what these tests might show.

The jelly on the belly one was over fast, it was such a huge relief when the radiographer, who was a very pleasant caring lady, said I could go to relieve myself as I really needed to cr*p. Then, unexpectedly .. and before I was sent to use the toilet… she asked if she could do another examination, the internal one, after I’d relieved myself! She said it showed up other things the first test couldn’t. She asked if I’d ever used Tampax & said the transducer was no larger & showed me it! Er, yes, it was & I used to use the Super Plus ones!

Now, I’m 64, never had a family, haven’t had sexual intercourse in over 20 years & after I agreed to the test as, let’s face it, I was wanting to know why I was having excrutiating abdominal pain, the radiographer couldn’t insert the thing! It just rammed against my pubic bone causing me to shout! She asked if I’d like to try to do it myself, I did try but, by then, I definitely wasn’t in the right mood to be raped by a solid rod of plastic. I didn’t know where to hide my face! From what the radiographer could see there was nothing to be concerned about though she stressed she had not seen some areas she expected to scan.

Now, November 2013, I’m being sent to the dept again as I’ve been having severe abdominal pain again in my right side. My Dr. wants me to have the same scans, just how do they think they’re going to stick that rod up me without me being knocked out?

I’ve had a bit of year being poked and prodded in various orifices and to top it all I’m due to have a scan in a week as my coil threads are lost. I really appreciate your candour(and humour) on the procedure and doesn’t sound like it’s any more uncomfortable than when the GP poked around with a swab hunting for my threads the other week!

The woman in the story had a much better experience than I did because her ultrasound wand wasn’t the size of my fist like mine was. I had it done at another hospital that was much smaller and not traumatic at all. This horror story was from my second one a month later. The tech actually had me lift my body off the table, into the air, so she could move the wand up, down, left, and right. This went on numerous times. My vagina doesn’t work that way. I came home in tears. It has been almost a week and I can still feel it. I am now having nightmares and can’t even think about sex with my husband. My advice is to look at the wand before you opt for a go at it.

I am due to go for a TVU on 8th Sept (2014). Having read this blog, it put my mind at ease. But then I read raerees experience and now I’m worried again. That must have been horrific and I really feel for you.
So, I will do what I always do in these situations and focus my thoughts on people who are in a far worse position, medically, than myself. Do I have to have months of horrendous treatments? No! Am I facing losing my life and leaving my family? No! Am I ill and have no home and no chance of treatment? No! There are people in the world putting up with far worse than this little half hour test! I shall be brave! Fingers crossed for me! x

Oh how i wish i had read this before having mine done! I didn’t even know this was part of a pelvic ultrasound! How naive of me to think it would only be the external ultrasound. My experience was almost identical to yours except i was mentally quizzing myself on the 50 states and their postal abbreviations. Oh and my ovaries seemed friendly enough. Lol. Thanks for sharing!

I’m really pleased someone’s written about this. I had one when I was 17 which went horribly (I was crazy nervous and no one had actually explained what was going to happen – they couldn’t actually do it because I tensed up and then the sonographer and doctor both complained about how I’d wasted their morning). Anyhow, I’m having another next week after seven years and this made me feel loads better about it. Thanks!

I had never had one prior to two days ago. And while the ultrasound itself was not painful in any way until right near the end, the sonographer couldn’t locate my left ovary and so kept trying. Bit uncomfortable, stung a bit but no big deal after you’ve experienced childbirth! The sonographer was great – gentle as and very nice.
And then.. the next day – the paid struck. Oh. my. gosh. It started as a dull ache in my ovaries and progressed as the day went on. Today it’s even worse. I feel like I’ve had abdominal surgery ( really not exaggerating!). Had no idea that they could cause pain afterward until researching today to see what on earth this pain is about.

I always ask if I *have* to have the TVU as I’m terrified to have one. I find the speculum painful and if I don’t have intercourse for a week or more when I do have sex I find it extremely intense and difficult at first. When I was shown the wand for TVU there was no way that wouldn’t hurt going in, let alone moving it around. Not all people’s bodies are the same so I don’t think one person can attest to whether or not this procedure will hurt.

Thank you for sharing your experience. The probe I encountered was much bigger than the one you described but that was in 2006. I am hoping when I have to go in for my next planned transvaginal the probe will now be as small as you described, otherwise the ultrasound might not be getting done.

I had one done Monday of this week and it’s going into Thursday. I first had one last year in March. From then and ongoing, I’ve had lower tummy pain. Like period pain. So I thought it was the little fibroid they found I had. Guess not, because I removed the fibroid with natural means. I let up on it the routine, and the pain remained, so I am scared about it. Anyway, had another TVU Monday and it’s still hurting! The other two times I had it done wasn’t pleasant and hurt a bit a few times while they moved the wand around. But this time there were more of those moments and it hurt bad. It had me moving backwards to get away from the pain. The tech also had me move my hips into the air several times too. That’s because there is poop in there. Yea, I I know, it’s embarrassing. And I had even gone hours earlier! Anyway, she said that was why for that.

I’m already paranoid about the pain that was there before and now I am paranoid about the more intense pain there! Jeez…I began to wonder if it was the original TVU that made my lower stomach hurt to begin with. ??! I am not up for sex either, btw, and I am moving around very slowly. The car hit bumps earlier tonight, going to the store and it hurt.

I had the most excruciating pain imaginable with the one I had a couple of days ago. I couldn’t figure out how it could possibly hurt that much. I was literally screaming in pain. When I sat up I found out why. The Tech had dropped all the lubrication off the wand. When your menopausal lubrication is important. Period!

Don’t worry if your transvagina test hurt. sometimes it’s normal our insides get spasms. Doesn’t mean there’s a problem. I went last week and it hurt so I was soooo worried because I read a bunch of negative scary things that if hurts there’s a problem! Not true all the time. My test came out negative. Just try to relax and take breath so you don’t get cramps or spams and scare you because it hurts. Good luck.
*hugs*

I have just had an ultrasound scan and they couldn’t find one of my ovaries. I have to go and get a tvu to find it. I am really scared because I had this done about ten years ago and found it really uncomfortable

I have to go for an abdominal scan next week and they have told me I also need a TVU to properly see the ovaries.

I am scared witless as, at 59, I have had vaginismus all my adult life and have never been able to have sex properly let alone smears or internal examinations. It has blighted my whole life and now it looks like it is going to stop me having proper investigations. Not sure what to do, to be honest.

So glad to find this post. My doc just ordered an ultrasound and said they might have to do a TVU. All I had was a mental image of the monster probe, which I couldn’t imagine without sedation considering how painful a speculum is. So I’ve been freaked out all afternoon. SOOO happy to read that it’s no worse, and that the probe is actually pretty small. I may still need a few stiff drinks before AND after, but at least I now feel I can do this. Thank you!!

I am a sonographer, and there are ZERO ultrasound endovaginal probes that are the size of a fist. They are INDEED the size of a large tampon, save for the very tip which may be as wide as 1.5 tampons.
Transvaginal scans are NOT rape, abuse, or anything of the sort. Yes, they are uncomfortable, usually amounting to an odd pressure against the cervix. If you are already having pain prior to the scan, are not sexually active, or are post-menopausal, you may experience more discomfort than the majority of patients.
These scans are extremely important in diagnosing subtle gynecological abnormalities that would not be picked up transabdominally, including things that could be cancerous.
As a woman, it disappoints me that other women would come here and try to frighten others out of having this procedure. While it is painful a small percentage of the time, it is no less necessary and important. Save your horror stories. I would hate for someone to suffer unnecessarily because she was too afraid to get this simple, quick, and generally painless test done!

Transvaginal ultrasounds do not cause lingering pain. Do you ladies who link your pain to an US also have pain after sex? Because intercourse is much more “traumatic.” I don’t think I need to explain why.
Have you talked to your doc about this pain? Do you have PID?

Oh, dear. Hopefully the sonographer can see them well enough through your abdomen! Make sure your bladder is full! Remember, tests should be attempten when the benefits outweigh the risks. In this case, the benefit of diagnosing or ruling out a problem, vs the risk of a painful exam due to your condition. It is always your choice. If you decide to have it done, try to relax as much as you can. The worry and stress may make the experience worse than it need be. Take care!

Thank you for writing this! I’m about to go for my first scan to see what on earth is causing me so much pain. My friend told me it was so so painful for her so I’m really scared right now as they think we have the same condition. But this has put me at ease. I can’t thank you enough.

Exactly. I’ve endured them several times, twice to inform me of miscarriages, more to inform me of healthy pregnancies, and more still as apparently my body is angry I’m not trying to get pregnant anymore (3 live births out of 8 total pregnancies was 5 too many miscarriages for me). Tomorrow I go in again for another pelvic ultrasound to find out what the hell is causing this pain. I’m going in because it is necessary for my health, which is far different than a woman being forced into going to appease crust old men stuck in the archaic mindset that they have any say in wtf a woman does with her body. So while I love the levity, having endured some missing ovary hunting as well, it’s best to not make light of the very really issue at hand with regards to forcing women into this sort of scan to humiliate, coerce, or bully her into keeping unwanted pregnancy.

Okay, I’m only posting this because there might be someone out there reading these comments who has this same experience and thinks she’s going crazy. I’ve had two of these, and anytime anything touches my cervix ever for any reason at all, there is intense pain. So these things are super painful for me, and I end up crying each time. So if you’re like me and reading this, you’re not the only one!

I just had this procedure done to me for the first (and please G-d the last) time today. February 22nd 2016. I am absolutely traumatized. It hurt so bad I screamed hysterically and my husband nearly broke down the door to run to my side. The doctor was rough and rude and he said that if I moved it could seriously damage me. Which makes me freaked out even more because I for sure moved in pain. They had to stop after 5 minutes and were upset saying that they could not complete the procedure and would inform my regular gynecologist . I was convulsing in pain in my stomach and my vagina. I felt beyond raped and violated. Which I had been years in the past so I know how it feels.